Objective To investigate the clinical application of the combined radical operation retaining the mandible with one-stage reconstruction using free flap in the patients with tongue carcinoma.Methods The combined radical operation retaining the mandible with one-stage reconstruction using free flap was performed in 39 tongue carcinoma patients.Results Postoperative healing well ,9 cases of recurrernce,the primary of which 5 cases ,4 cases of cervical recurrence,the recurrence of cases in all 3 cases of T3 ,T4 ,6 cas es of cervical lymph node and distant contralateral transfer of 5 cases,includlng 2 cases of T3,T4 of 3 cases after 1 to 3 years.Conclusion The combined radical operation of tongue cancer,passed the stringent selection case,preserve the integrity mandible is completely feasible.

Objective To research the clinical effect of treating sagittal fracture of the mandibular condyle (SMFC). Methods 20 cases of SMFC patients were treated by removing the severe allotopic broken bone block of SMFC and adopting conservative intermaxillary traction. Results All these patients had no adverse side effects such as secondary infection,limitation of mouth opening, arthrocleisis, occlusion disorder and facial deformity. Following-up from the 8th month to the 4th year indicated that their occluding relation and opening movement recovered well. The CT graphs and panoramic radiographs of operated patients discovered that the injured condylar processes had become roughly proper or a little less proper. Conclusion Reasonably removing the severe allotopic broken bone block of SMFC and adopting conservative intermaxillary traction are the more effective methods to cure SMFC ,which is easy to be grasped and popularized.

Asthenospermia accounts for about 30% of the causes of male infertility. Currently, most drugs for asthenospermia lack specificity and desirable therapeutic efficiency. An insight into the pathogenesis of asthenospermia is important for the development of specific therapies for this disease. The protein Na+/K(+)- ATPase α4 isoform (NKA4) presents in both mature testis tissue and the sperm tail, the absence or reduced activity of which may significantly decrease sperm motility. Ouabain is a natural inhibitor of NKA4, suppressing its activity by specifically binding the ouabain site in it. The hypothalamus and adrenal cortex excrete an ouabain-like steroid hormone called endogenous ouabain (EO), which may be associated with the pathogenesis of asthenospermia by inhibiting the activity of NKA4, affecting Na+/H+ exchange, Na+/Ca2+ exchange and sperm cell membrane potential, and eventually reducing sperm motility.
Asthenozoospermia ; physiopathology ; Humans ; Male ; Membrane Potentials ; Ouabain ; chemistry ; Protein Isoforms ; Sodium-Potassium-Exchanging ATPase ; antagonists & inhibitors ; Sperm Motility ; Sperm Tail ; Spermatozoa ; Testis

Objective To explore the clinical effect of detection of serum procalcitonin (PCT), C-reactive protein (CRP)and white blood cell (wBC)on diagnosis and treatment of severe pneumonia in children.Methods A total of 189 cases of pediatric patients with pneumonia including 51 severe pneumonia cases (severe pneumonia group)and 138 common pneumonia cases (common pneumonia group)treated from Mar 2014 to Dec 2014 and 30 healthy cases (control group)were enrolled,and the level of PCT,CRP and wBC of all cases were detected.Results The levels of PCT before treatment in severe pneumonia group,common pneumonia group,and control group were 1.12(0.44 ~3.07)ng /ml,0.14 (0.09 ~0.26) ng /ml and 0.03(0.01 ~0.06)ng /ml respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The levels of CRP before treatment in severe pneumonia group,common pneumonia group,and control group were 82.2(25.9 ~120.3 )mg /L,10.8 (5.3 ~23.9)mg /L and 3.2 (2.1 ~6.9) mg /L respectively,and there were significant differences among three groups (P ﹤0.05,respectively).The counts of wBC before treatment in severe pneumonia group,common pneumonia group,and control group were 10.1 (9.1 ~14.1 )×109 /L,8.8(6.8 ~1 1.7)×109 /L and 6.2(4.8 ~7.9)×109 /L respectively,and there was significant difference only between severe pneumonia group and control group (P ﹤0.05 ).The level of PCT and CRP significantly decreased in severe pneumonia group after one week of treatment[PCT:0.15(0.09 ~0.24)ng /ml,CRP:9.9(3.6 ~19.0)mg /L](P ﹤0.05),but there was no significant differ-ence of wBC counts in severe pneumonia group between after and before treatment[8.5(6.3 ~9.8)×109 /L vs.10.1 (9.1 ~14.1 )×109 /L](t =1.312,P =0.205 ).After two days of anti-inflammatory treatment in severe pneumonia group,serum PCT dropped to 44% of the level before treatment,and smoothly dropped to nearly 10% of the basic value every two days.Serum PCT was correlated with serum CRP in children with pneumonia(R2 =0.550 4,P ﹤0.05).Conclusion The combined detection of PCT and CRP could provide important guidance for the differential diagnosis,treatment and prognosis for severe pneumonia in children.

Acquired Immunodeficiency Syndrome ; diagnosis ; therapy ; Female ; Humans ; Male ; Syphilis ; diagnosis ; therapy

Objective To investigate the impact of gantry angles on the position accuracy of buildin multi-leaf collimator (MLC) during static (step & shoot) intensity modulated radiotherapy (IMRT).Methods The position accuracy of MillenniumTM 60 pairs multi-leaf collimator (MLC) in Varian 23EX medical linear accelerator during 10 fractions of treatments with static intensity modulated radiotherapy (IMRT) was retrospectively analyzed by resolving dynamic therapy log files and MLC planning files.The single leaf position deviation and gap deviation of each MLC pairs were compared between expected values and actual outcomes.The impact of gantry angle on MLC position accuracy was also investigated with paired t-test between vertical and horizontal beams.Results All the MLC position deviations ranged within ± 1.0 mm,while the gap deviations were at the range of ± 1.5 mm.The statistical standard deviation of MLC position deviations among fractions was less than 0.06 mm.After all the 60 pairs of MLC leaves were taken into account,the M LC position deviation in the field of 103° was smaller than in the field of 0° (t =58.74,P ＜ 0.01),but there was no significant difference between 257° and 0°,while only the moving leaves were put into consideration,the MLC position deviation in the field of 103° was still smaller than in the field of 0°,but the MLC position deviation in the field of 257° was slightly higher than in thefield of 0° (t =41.95、-4.47,P ＜ 0.01).Conclusions The MillenniumTM 60 pairs MLC in Varian 23EX medical linear accelerator meets the mechanical quality assurance requirement during static IMRT treatments.The MLC positioning showed stable repeatability among treatment fractions.Although the MLC position accuracy is slightly affected by gravity from different gantry angles,but still meets the mechanical QA requirements for medical linear accelerator.This dynamic analysis method is expected to be a novel strategy which may improve the existing QA protocols.

Objective To compare the safety,effectiveness and predictability of laser in situ keratomileusis (LASIK) with fem- tosecond laser (IntraLase) and mechanical microkeratome (Moria M2,head 90?m).Design Prospective clinical study.Participant 148 patients (274 eyes) with high myopia received operation of LASIK.Method The patients were assigned to receiving LASIK with corneal flap creation by Intralase femtosecond laser (134 eyes of 76 patients) or Moria 90 keratome (140 eyes of 72 patients),both groups receiving eximer laser ablation with VISX Star S4.Followed-up examinations such as visual acuity,refraction,wavefront aberra- tion,etc.were scheduled for 1 day,1 week,1 month and 3 months postoperatively.Main Outcome Measures Visual acuity,refrac- tion,wavefront aberration,Schirmer test and tear film breakup time(BUT).Results At 3 months after operation,108 eyes (80.6%) of IntraLase group had UCVA better than or equal to BSCVA preoperatively,showing no statistically significant difference to microker- atome group (116 eyes,82.9%,P=0.642).The mean residual spheroequivalent of refraction of IntraLase group was -0.49?0.70D,show- ing no statistically significant difference to microkeratome group (-0.56?0.83D,P=0.448).The mean Schirmer test of Intralase group was 9.5?4.0mm,showing no statistically significant difference to microkeratome group (9.5?7.2mm,P=0.950).The mean BUT of IntraLase group was 7.9?4.3s,showing no statistically significant difference to microkeratome group (8.08?5.48s,P=0.869).The postoperative higher-order aberrations of the IntraLase group was 0.480?0.133?m,lower than that of microkeratome group (0.578?0.169?m,P=0.034). Conclusions Thin-flap LASIK with femtosecond laser and mechanical keratome flap creation are both safe,effective for the correction of high myopia,showing good predictability and stability.Femtosecond laser has slightly better clinical outcomes than microkeratome.

Objective To investigate the influencing factors for eye cyclotorsion and pupil centroid shift during LASIK.Design Non-controlled retrospective case series.Participant 131 patients (262 eyes) with myopia received bilateral LASIK.Methods Eye cy- clotorsion and pupil centroid shift were measured with Custom Vue~(TM) software during operation and compared with age,gender,right or left eye,flap-making method,spherical equivalent (SE),pupil diameter before and during operation.Main Outcome Measures The de- gree of eye cyclotorsion and distance of pupil centroid shift during LASIK.Results The mean eye cyclotorsion during LASIK was 3.07??2.07?(0?-8.6?).The mean pupil centroid shift was 0.33?0.14 mm (0.04-0.51 mm).The eye cyclotorsion was relevant to preoperative pupil size,difference of pupil size before and during operation,and preoperative SE (r=0.188,0.156,0.130,all P7.0 mm was higher than that of with pupil diameter≤7.0mm (3.35??2.17?,2.71??1.89?,P=-0.014).Pupil centroid shift was higher in fight eyes than that in left eyes (0.39?0.12 mm,0.28?0.13 mm,P=0.000).Conclu- sion Eye cyclotorsion and pupil centroid shift during LASIK can be measured with Custom Vue~(TM) system.The eye cyclotorsion may be influenced by the preoperative pupil size.The pupil centroid during LASIK was more significant in the right eyes than in the left eyes.

Objective To investigate the technique of drain air, cryotherapy, and explant (DACE) of operation for superior bullous retinal detachment (SBRD). Methods In the DACE procedure, drainage and air or balanced salt soultion (BSS) injection were carried out first, with the intention of flattening the retina before localization of retinal hole, cryotherapy out of choroid and scleral buckling. Results In 42 SBRD eyes, 40 underwent the operation with DACE technique. In 23 eyes injected with BSS instead of air, 5 should be injected air due to no avail for flattening deeply retinal detachment, and 1 needed scleral buckling due to new retinal tear after DACE procedure two weeks. During the follow up, all retinae attached. Conclusions The DACE technique is very useful and effective in upper ballooned retinal detachment due to single hole or breaks localized in small area between the 10 and 2 o′clock meridiant. BSS instead of air injection can eliminate the difficulty of observation of retinal breaks from the presence of air in some cases.

Objective To explore the feasibility of laparoscopic-assisted partial and subtotal colectomy and per anum intrarectal pull-through procedures for Hirschsprung's disease-allied disorder(HAD).Methods From October 1999 to May 2006,38 infants and children with HAD or Hirschsprung's disease(HD) associated with HAD,to whom conservative treatments proved ineffective or relapse occurred,were treated by laparoscopic-assisted partial or subtotal colectomy and per anum intrarectal pull-through procedures.Four 5 mm trocars were inserted at the edge of umbilicus,right upper,right lower and left center quadarant of abdomen when subtotal colectomy was carried out.Two trocars were placed in the left side,lied in left upper and mid lower quadarant of abdomen respectively.Colon descendens,colon transversum,colon ascendens and ileocecal junction lateral peritoneum were mobilized under laparoscope.The operation on anus was referred to modified Soave procedures.Results 38 patients underwent the operations successfully.Left hemicolon resection were performed in 9 cases,with operation time being 110-180 min(mean,135 min).Subtotal colectomy were performed in 29 cases and colon ascendens were rotated reversal clockwise 270? and pulled down using Deloyers procedures,lengths of remaining colon ascendens being 7-13 cm(mean,11.5 cm),operation time being 140-220 min(mean,175 min),intraoperative blood loss being 15-70 ml(mean,35 ml).Postoperative pathological diagnosis showed 10 cases of intestine neuron developmental anormaly(IND),3 cases of hypoganglionosis(HG),4 cases of immature gangliocyte(IGC),9 cases were not classified,6 cases of HD complicated with IND,2 cases of HD complicated with HG,4 cases of HD complicated with ICG.38 cases were followed up for a mean of 3 years and 5 months(range,6 months to 7 years).9 cases of left hemicolon resection had 1-2 stools per day at 6 months postoperatively without stoma stenosis and constipation recurrence.Conclusions Laparoscopic-assisted partial or subtotal colectomy and radical per anum pull-through procedures for HAD are safe,effect,feasible,with minimal invasion,but some laparoscopic procedure experiences are required.